决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:NK and T-lymphocyte Kinetics Predict Outcome in Myeloma Patients Treated With Elotuzumab, Lenalidomide Plus Dexamethasone.
NK and T-lymphocyte Kinetics Predict Outcome in Myeloma Patients Treated With Elotuzumab, Lenalidomide Plus Dexamethasone.
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NK 细胞和 CD8 + Treg 的变化预测了长持续时间 ERd 和 PD,维持低 CD4/8 比值预测了长 TTNT,表明这些淋巴细胞分数可能是骨髓瘤患者 ERd 持久治疗效果的生物标志物。
埃罗妥珠单抗是一种抗SLAMF7单克隆抗体,可通过增强抗体依赖性细胞介导的细胞毒作用和减少SLAMF7 + CD8 + CD57 + 调节性T细胞(Tregs)来增强免疫活性。这项多中心观察性研究通过使用外周血样本的双色流式细胞术,探讨了接受埃罗妥珠单抗、来那度胺和地塞米松(ERd)治疗的骨髓瘤患者中淋巴细胞的动力学。
本研究纳入21例患者。ERd的中位持续时间为22.6个月,长持续时间ERd的截断时间为两年。
在长疗程ERd组中,CD2 + CD16 + 和 CD16 + CD57 - NK细胞随时间显著增加,与短疗程ERd组相比(p=0.035 和 p<0.001)。在ERd结局为疾病进展(PD)的患者中,CD8 + 和 CD16 - CD57 + 淋巴细胞(被鉴定为低活性NK细胞或SLAMF7 + Tregs)显著增加,与非PD组相比(p=0.023 和 p<0.001)。长疗程ERd组的平均CD4/CD8比值和CD19 + 淋巴细胞计数显著低于短疗程ERd组,尽管它们的动力学随时间没有变化(p=0.016 和 p=0.011)。根据ROC曲线,当CD4/CD8比值的截断值为0.792时,低CD4/CD8组的两年至下次治疗时间(TTNT)显著长于高CD4/CD8组(80.0% vs. 15.0%,p=0.024)。
Twenty-one patients were included in this study. The median duration of ERd was 22.6 months, and the cutoff time for long-duration ERd was two years.
The CD2 + CD16 + and CD16 + CD57 - NK cells were significantly increased over time in the long-duration ERd group compared to those in the short-duration ERd group (p=0.035 and p<0.001). The CD8 + and CD16 - CD57 + lymphocytes, identified as low-activity NK cells or SLAMF7 + Tregs, were significantly increased in the patients whose ERd outcome was progressive disease (PD) compared to those in the non-PD group (p=0.023 and p<0.001). The mean CD4/CD8 ratio and CD19 + lymphocyte counts in the long-duration ERd group were significantly lower than those in the short-duration ERd group, although the kinetics of them did not change over time (p=0.016 and p=0.011). When the cutoff value of CD4/CD8 ratio was 0.792 according to ROC curves, the two-year time to next treatment (TTNT) in the low CD4/CD8 group was significantly longer than that in the high CD4/CD8 group (80.0% vs. 15.0%, p=0.024).
The change in NK cells and CD8 + Tregs predicted long-duration ERd and PD, and maintaining low CD4/8 ratio predicted long TTNT, suggesting that these lymphocyte fractions might be biomarkers for a durable therapeutic effect of ERd in myeloma patients.
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